The original CFIR (Laura J. Damschroder et al. 2009) described “incentives and rewards” that include extrinsic incentives such as goal-sharing awards, performance reviews, promotions, and raises in salary as well as less tangible incentives such as increased stature or respect (C. D. Helfrich et al. 2007; Klein, Conn, and Sorra 2001). Tangible and/or intangible incentives and rewards, disincentives and punishments, or performance feedback can help to support implementation and delivery of the innovation (Klein, Conn, and Sorra 2001; C. D. Helfrich et al. 2007; Balliet, Mulder, and Van Lange 2011; Clark and Wilson 1961) and is affirmed by more recent literature (Tagliabue, Sigurjonsdottir, and Sandaker 2020).
Financial incentives and performance evaluations are important for reinforcing beliefs that behavior will lead to desirable results (D. H. Gustafson et al. 2003; J. Leeman, Baernholdt, and Sandelowski 2007). Strong incentives were found to be positively associated with implementation effectiveness (C. D. Helfrich et al. 2007; Klein, Conn, and Sorra 2001). Well-designed incentives can bolster the degree to which new behaviors are positively or negatively valued, which heightens intention to change, a precursor to actual change (Gershon et al. 2004). A four-item “reward system” subscale is included as part of the Competing Values Framework measure of culture, and it was found that the number of different types of compensation incentives used is positively associated with comprehensiveness of the use of best practices by healthcare organizations (Shortell et al. 2001).